Journal article
Medication refractory restless legs syndrome: Real-world experience
Journal of the neurological sciences, Vol.463, pp.123121-123121
08/15/2024
DOI: 10.1016/j.jns.2024.123121
PMID: 38968665
Abstract
Background: Restless Legs Syndrome (RLS), impacting 5-13% of the population, poses challenges in long-term management. A knowledge gap exists in predicting resistance to first-line therapies. Objective: To identify demographic and clinical factors predictive of refractory cases. Methods: This retrospective study, conducted at the Parkinson's Disease Center and Movement Disorders Clinic, Baylor College of Medicine, Houston, Texas (January 2018 to September 2023) identified all patients with RLS evaluated during the pre-specified period and compared clinical and demographic data between medication- refractory ("malignant") group and "benign" cohort. Results: Among 132 patients with RLS, 23 (17.4%) were categorized as medication-refractory. This cohort was characterized by a significantly lower mean age at onset (39.3 vs. 53.5 years, p = 0.0005), longer disease duration (26.7 vs. 14.0 years), and a higher prevalence of a positive family history of RLS among first-degree relatives compared to the "benign" group (56.5% vs. 15.5%, p = 0.003). Furthermore, compared to the "benign" group, in the refractory group dopamine agonists were initiated as the primary medication at a significantly higher rate (p p = 0.006). Conclusion: Our study found that a younger age at disease onset, prolonged disease duration, initial use of dopamine agonists, and a positive family history increased the likelihood of refractory RLS. We caution against the use of dopamine agonists, especially in young patients with RLS. Additionally, botulinum toxin might be considered a viable second-line treatment, especially for patients with otherwise medically-refractory RLS.
Details
- Title: Subtitle
- Medication refractory restless legs syndrome: Real-world experience
- Creators
- Peyman Petramfar - Baylor College of MedicineJoseph Jankovic - Baylor College of Medicine
- Resource Type
- Journal article
- Publication Details
- Journal of the neurological sciences, Vol.463, pp.123121-123121
- DOI
- 10.1016/j.jns.2024.123121
- PMID
- 38968665
- NLM abbreviation
- J Neurol Sci
- ISSN
- 0022-510X
- eISSN
- 1878-5883
- Publisher
- Elsevier
- Number of pages
- 5
- Language
- English
- Date published
- 08/15/2024
- Academic Unit
- Neurology
- Record Identifier
- 9985013726602771
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